Breast Problems

Breast appearance issues

by Frederick R. Jelovsek MD

Nipple retraction

I know I should see a doctor but I am scared. I have a nipple that regularly retracts, including the areola. At random the nipple sinks in as you watch it and it is very painful. There is no history of any problems in my family nor have I had any problems. I am 30 years old. Any ideas before I find out the expected?

I suspect you are afraid because you think this may be a sign of breast cancer. Most cases of nipple retraction are almost always a benign muscle retraction of the nipple to touch or cold. Some are due to fibrous tissue.

Some are due to a benign condition called mammary duct ectasia. Occasionally it turns out to be associated with breast cancer. This is less likely at your age but because it is possible you have to go and get it examined.

Pain is usually against breast cancer (10%) but sometimes it can be associated. Below, please find an abstract which I hope reassures you more than frightens you. You must have it evaluated by your doctor but most likely it will turn out to be benign.

A detailed analysis by questionnaire of breast pain in 460 newly referred patients at a specialized breast clinic revealed that only 1.5% of patients with pain had an early breast cancer. Of all 44 cancers 8 were painful but only 4 considered early. All these had nipple retraction. We conclude that although breast pain is rarely associated with cancer, localized pain must be fully investigated to exclude this diagnosis.